Hand Dislocation

Dislocations in the hand are common injuries in sports and in occupational settings, often appearing to be minor. If the athlete, trainer, or coach has already reduced the dislocation, it appears unimpressive compared to a major knee injury or a shoulder dislocation.

Injury to the hand so that adjoining bones are displaced and no longer touch each other. The ulnar nerve is likely to be injured with this dislocation. If the ulnar nerve is involved, surgery is necessary to prevent permanent damage.

BODY PARTS INVOLVED

• Hand bones (carpal and metacarpal).
• Ligaments that hold the hand bones in the proper position.
• Soft tissue surrounding the dislocation site, including periosteum (covering to bone), tendons, blood vessels and connective tissue.
• Ulnar nerve.

Causes

• Direct blow to the hand or falling on an outstretched hand (most common cause).
• End result of a severe hand sprain.

Signs & Symptoms

• Excruciating pain at the time of injury.
• Loss of normal hand function.
• Severe pain when attempting to move the hand.
• Visible deformity if the dislocated bones have locked in the dislocated position. Bones may spontaneously reposition themselves and leave no deformity, but damage is the same.
• Tenderness over the dislocation.
• Swelling and bruising at the injury site.
• Numbness or paralysis below the dislocation from pressure, pinching or cutting of blood vessels or nerves

Treatment

Follow your doctor's instructions. Instructions are supplemental.

If cast is not necessary:

• Use ice soaks 3 or 4 times a day. Fill a bucket with ice water, and soak the injured area for 20 minutes at a time.
• After 24 to 48 hours, apply heat instead of ice if it feels better. Use heat lamps, hot soaks, hot showers or heating pads.
• Take whirlpool treatments, if available.
• Wrap the hand with an elasticized bandage between treatments.
• Massage gently and often to provide comfort and decrease swelling.

Home Diet

• Drink only water before manipulation or surgery to correct the dislocation. Solid food in your stomach makes vomiting while under general anesthesia more hazardous.
• During recovery, eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.

Prevention Tips

Initial injury usually cannot be prevented. After healing, protect vulnerable hand joints with wrapped elastic bandages, tape wraps, felt or foam-rubber pads or plastic splints.